Development of a second generation anti-Müllerian hormone (AMH) ELISA

AMH is a glycoprotein dimer composed of two 72kDa monomers linked by disulfide bridges. It belongs to the transforming growth factor-β family. AMH performs various physiological functions. In males, AMH is secreted by the Sertoli cells of the testis. During embryonic development, AMH is responsible for Müllerian duct regression. AMH continues to be produced by the testicles until puberty and then decreases slowly to residual post-puberty values. In females, AMH is produced in small amounts by ovarian granulosa cells after birth, until menopause, and then becomes undetectable. A two-step, sandwich-type enzymatic microplate assay has been developed to measure AMH levels in 20 μL of sample in less than 3h. AMH calibrators range from 0.2 to 28 ng/mL. The antibodies used in the assay bind to the mature region of AMH, which is more stable to proteolysis compared to prohormone region. The AMH Gen II assay (Beckman Coulter, Inc., Webster, Texas) was standardized to the Immunotech (IOT, Beckman Coulter, Inc., Marseilles, France) AMH assay. AMH Gen II, when compared to IOT using 120 serum samples in the range of 0-20.4 ng/mL yielded a correlation coefficient of 0.98 and a slope of 1.0. Total imprecision, calculated on four samples over 40 runs, four replicates per run, between two lots using CLSI EP5-A guidelines, was 5.7% at 3.8 ng/mL, 7.7% at 4.4 ng/mL, 5.8% at 14 ng/mL and 5.3% at 16.4 ng/mL. The average analytical sensitivity calculated by the interpolation of the mean plus two standard deviations of 16 replicates of the zero calibrator on two independent lots was 0.08ng/mL. Dilution and spiking studies showed an average recovery of 91-110%. Lot-to-lot comparison of two independent lots testing 38 serum samples (1.5-33 ng/mL range) yielded a slope of 1.01, intercept of -0.08 ng/mL and r of 0.99. When potential interferents (hemoglobin, triglycerides, and bilirubin) were added at two times the physiological concentrations, AMH concentrations were within ± 10% of the control. A highly specific and reproducible microplate AMH Gen II assay has been developed to standardize the measurement of AMH between methods. The performance of the AMH Gen II assay is ideal for investigation into the physiologic roles of AMH in men and women.